President Donald Trump marked the beginning of his second term on Monday with a sweeping executive order aimed at dismantling key initiatives from the Biden administration. The order targets a range of policies, from healthcare and gender equality to the United States’ role in international organizations, reflecting a clear reversal of Biden’s priorities.
The “initial rescissions” order, signed by Trump before a cheering crowd at the Capital One Arena, takes aim at several major initiatives, which the new administration characterizes as inflammatory, inflationary, and potentially unlawful. The policies rescinded include Biden’s 2022 directive to pilot Medicare and Medicaid models designed to reduce healthcare costs, as well as measures that sought to expand the Affordable Care Act (ACA) and protect gender-based rights.
One of the most significant reversals was the rollback of the October 2022 Medicare and Medicaid pilot program, a cornerstone of Biden’s healthcare agenda. This initiative aimed to explore alternative models for healthcare delivery, including testing new ways to lower costs. Trump’s administration also targeted Biden’s 2022 drug pricing reforms, which aimed to allow the government to negotiate the price of prescription drugs under the Inflation Reduction Act.
Trump also focused on the nation’s response to the COVID-19 pandemic, repealing policies related to vaccine distribution, treatments, and pandemic preparedness. His administration also froze federal hiring—aside from certain exceptions—and called for federal employees to return to their offices full-time.
In a move that echoes his earlier criticisms of global health organizations, Trump also ordered the U.S. to begin the process of withdrawing from the World Health Organization (WHO), which he has long accused of mishandling the COVID-19 response.
Healthcare and Drug Pricing Initiatives Targeted
Under Trump’s new executive order, several of Biden’s healthcare initiatives were rolled back. One of the most notable is the rescinding of an executive order that extended enrollment periods for Affordable Care Act (ACA) plans and provided additional funding to third-party enrollment assistance programs. These measures contributed to a surge in ACA enrollment, which nearly doubled under Biden, reaching approximately 24 million people. The expansion was largely fueled by government subsidies that reduced the cost of premiums for many enrollees.
Trump’s order also rescinds Biden’s efforts to reform drug pricing through the Center for Medicare and Medicaid Innovation (CMMI). Biden had initiated several pilot programs to experiment with more affordable drug pricing models, including efforts to provide Medicaid programs with multi-state purchasing agreements for costly therapies, and initiatives to reduce payments for accelerated FDA-approved drugs. Trump’s administration is now expected to appoint Abe Sutton, a former White House and Department of Health and Human Services aide, to oversee CMMI’s efforts moving forward.
COVID-19 Policies Rescinded
On the public health front, Trump dismantled multiple Biden-era policies related to the COVID-19 response. These included efforts to expand testing, increase research into treatments, and establish long-term economic relief measures in case of future pandemics. The Biden administration had also focused on strengthening international cooperation for pandemic preparedness, but Trump’s order cuts many of these programs.
Gender and Education Policy Reversals
In a move aligned with his campaign promises, Trump also revoked Biden’s initiatives aimed at protecting gender and sexual identity rights. Notably, he rescinded a 2022 policy that sought to protect LGBTQ+ students and eliminate practices like conversion therapy both domestically and abroad. The president also withdrew policies that promoted protections based on gender identity in educational settings. Furthermore, Trump axed Biden’s 2021 creation of the Gender Policy Council, initially led by Jennifer Klein, a former official in both the Obama and Clinton administrations.
Trump’s executive action has sparked concerns that these policy changes may lead to legal challenges or congressional pushback, as some of Biden’s actions were tied to laws passed by Congress. As with any major executive order, the administration’s moves will likely be tested in the courts, potentially delaying or modifying the impacts of these sweeping reversals.
In the coming months, the effects of Trump’s order will unfold, with potential shifts in the regulatory landscape and new policies that could reshape the federal government’s approach to healthcare, gender equality, and international cooperation.
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